6 provinces on red alert for dengue fever

The Jakarta Post, Jakarta

The government declared on Monday an extraordinary occurrence of dengue fever in six provinces after 102 people died while another 4,700 are being treated for the disease.

Minister of Health Siti Fadilah Supari said after a Cabinet meeting the alert status had been imposed in Jakarta, West Java, East Kalimantan, South Sulawesi, West Nusa Tenggara and East Nusa Tenggara, which were among the 12 provinces hardest hit by the outbreak last year.

"There is a significant increase in the number of patients with dengue fever. However, the figure is less than that of last year," she said.

Under the extraordinary emergency, state hospitals are ordered to treat patients in third class wards for free. Such a status is declared when the number of patients doubles that of the previous year.

The government announced an extraordinary occurrence of dengue fever in 12 provinces affected by the dengue outbreak in February last year and allocated Rp 500 million (US$54,600) in cash and medicine for each of the local governments.

The outbreak was considered over and the alert status lifted after more than three months, during which 59,321 cases and 669 deaths were recorded in 24 out of 32 provinces. Jakarta and East Java were the areas hardest hit by the outbreak, where cases accounted for half of the national figure.

Dengue fever outbreaks have shown a rising trend between 1999 and 2004, with the most virulent DEN-3 serotype blamed for the major outbreak last year.

"We have disseminated information about the disease to the public and are examining which strain has caused this year's outbreak," Siti said. She added the government had not yet obtained the data on the virus that has sparked the current outbreak.

Four distinct, but closely related, serotypes cause dengue, with the Aedes aegypti mosquito the vector. All four serotypes, DEN-1, DEN-2, DEN-3 and DEN-4, have been found in dengue patients here.

Dengue symptoms can range from mild, flu-like symptoms to its most severe form, called dengue hemorrhagic fever, or DHF. DHF causes damage to the blood vessels, leading to spontaneous bleeding and shock, and can be fatal.

Many patients die due to being admitted to hospital too late.

While 17 people have succumbed to dengue fever in Jakarta so far, two more people have died in West Java, bringing the death toll to 32 in the neighboring province.

A West Java health agency official, Fatimah Resmiati, said on Monday the outbreak had affected 25 regencies and municipalities across the province. Subang and Majalengka are the regencies hit hardest, she added.

"We have dispatched medical teams to the two regencies to help local health agencies cope with the outbreak," Fatimah said, adding that 837 people had contracted the disease in this year's outbreak.

The outbreak affected 18,682 people with 211 fatalities last year in West Java.

Fatimah said her office had allocated Rp 400,000 to subsidize each economically disadvantaged patient. The local administration has provided Rp 5 billion to pay for the medical treatment of dengue fever patients.

Dengue fever was first recorded in 1968 in Surabaya and Jakarta, when it killed 24 people.

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